| Regimental number | 6864 |
| Place of birth | Neilborough Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Milson's Point, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Rachael Rayner, 85 Alfred Street, Milson's Point, North Sydney, New South Wales |
| Enlistment date | 21 April 1917 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/36/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Port Melbourne on 16 July 1917 |